Objective To evaluate the effectiveness of spiral stone dislodger combined with pneumatic lithotriptor under ureteroscopy for managing upper ureteral stones. Methods 106 patients with upper ureteral stones with spiral stone dislodger combined with pneumatic lithotriptor under ureteroscopy were treated. The transverse diameter of the stones was 4～12mm and the vertical length 6～15mm. Results 87.7% (93/106) stones were fragmented for one session of treatment. 8 cases were pushed upward then undergoing extracorporeal shock wave lithotripsy(ESWL) after surgical operations. Operations in 5 cases had to be changed to open surgery,and ureteral perforations happened in 1 case. Conclusion Successful entrance of the uretersocop is a prerequisite for crushing the stone,appropriate fixation of the stone is the key to their crushing,spiral stone dislodger is an effective means of fixing ureteral stones.

Objective To evaluate the efficacy and safety of Chushizhiyang ointment for the treatment of mild atopic dermatitis in infants.Methods A multicenter,randomized,open,active-controlled clinical trial was conducted.A total of 204 infants with atopic dermatitis were enrolled and randomly divided into 2 groups to be topically treated with Chushizhiyang ointment (test group,n =103) and hydrocortisone butyrate cream (control group,n =101),respectively,for 2 weeks.The improvement of eczema area and severity index (EASI) scores and quality of life was evaluated at 7 days and 14 days after the treatment,so was the incidence of adverse events and adverse reactions.Results Ninety-eight infants in the test group and 101 in the control group were included in the full analysis set,which revealed that the disease severity significantly decreased after the treatment in both groups.The EASI scores at the baseline and on days 7 and 14 were 2.47 ± 4.04,0.92 ± 1.25 and 0.39 ± 1.04 respectively in the test group,as well as 2.13 ± 2.01,0.85 ± 1.58 and 0.45 ± 1.65 respectively in the control group.Furthermore,the test group and control group both showed that EASI scores on days 7 and 14 significantly decreased compared with those at the baseline (the test group:T =-1 666,-1 793,respectively,both P ＜ 0.001;the control group:T =-1 951,-1 941,respectively,both P ＜ 0.001).No significant differences in EASI scores at the baseline or on days 7 and 14 were observed between the test group and control group (all P ＞ 0.05).The response rates in the test group and control group were 47.96％ (47/98) and 55.44％ (56/101) respectively on day 7,as well as 79.59％ (78/98) and 84.16％ (85/101) respectively on day 14,and there were also no significant differences between the two groups (both P ＞ 0.05).The adverse reactions mainly manifested as erythema,itching and scaling in the test group,as well as hypopigmentation,telangiectasia,scaling and hyperpigmentation in the control group.No significant difference in the incidence of adverse events was found between the test group (2.9％,3/103) and control group (6.9％,7/101).Conclusion Chushizhiyang ointment shows definite efficacy for mild atopic dermatitis in infants with good safety and tolerability,and can be a teatment option for mild atopic dermatitis in infants.

OBJECTIVETo verify the pharmacological hypothesis of prescriptions by studying the targeted distribution of major components in stewed rhubarb in the rat model with acute pancreatitis (AP).

METHODNormal SD rats (control group, n = 5) and the AP model induced with intraperitoneal cerulein (model group, n = 5) were taken as the experimental objects. Rats of the two groups were orally administered with stewed rhubarb granules (20 g x kg(-1)). Their heart, liver, spleen, lung, kidney and pancreas were collected two hours after the administration. Such constituents as emodin, chrysophanol, physcion, rhein and aloe-emodin and their concentrations in each tissue homogenate were detected by high performance liquid chromatography-mass-mass.

RESULTAloe-emodin and physcion in stewed rhubarb whose concentrations in liver and kidney of normal rats were higher than that in pancreatic tissues, while the distribution spectrums and concentrations of the remaining components in pancreatic tissues had no significant difference with that of other organs. The concentrations of emodin, aloe-emodin, rhein and chrysophanol in stewed rhubarb in pancreatic tissues of the AP model group were higher than that in other tissues and organs, while their concentrations in pancreatic, renal and splenic tissues were notably higher than that in the normal group.

CONCLUSIONIn the conditions of AP, effective components in stewed rhubarb show a targeted distribution feature in pancreas, which provides experimental basis for the pharmacological hypothesis of prescriptions.

Acute Disease ; Animals ; Anthraquinones ; pharmacokinetics ; pharmacology ; therapeutic use ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacokinetics ; pharmacology ; therapeutic use ; Male ; Organ Specificity ; Pancreatitis ; drug therapy ; metabolism ; Rats ; Rats, Sprague-Dawley ; Rheum ; chemistry

Objective To explore the application value of endoscopic thyroidectomy via breast approach without transection anterior cervical muscle group .Methods The clinical data of 130 patients which treated by thyroidectomy without transection ante‐rior cervical muscle group were analyzed ,retrospectively .There were 68 cases treated by endoscopic thyroidectomy via breast ap‐proach and 62 cases treated by conventional thyroidectomy .Results 68 patients underwent endoscopic thyroidectomy ,the mean time of operation was(127 .66 ± 29 .56)min ,which was longer than that in conventional group (89 .06 ± 24 .25)min(P<0 .01) ,but blood loss was significantly less in endoscopy group than that in conventional group(19 .13 ± 7 .37)mL vs .(50 .17 ± 29 .28)mL . (P<0 .01) .The patients treated by endoscopic thyroidectomy with neck pain induration were less than that in conventional group (1 case vs .7 case) ,P<0 .01 ,and the nerve dysfunction were (4 case vs .3 case) ,P>0 .05 ,the nerve dysfunction had no significant difference .Conclusion Endoscopic thyroidectomy via breast approach without transection anterior cervical muscle group has less blood loss ,lower neck pain induration rate ,hidden incisions and excellent cosmetic benefits .The method is safe and feasible .

Objective To study the influence of different body serum iron levels on follicle stimulating hormone (FSH),luteinizing hormone (LH) and uterine ovarian index,and explore the body serum iron level effects on female mice sexual maturity further.Methods 36 three weeks C57BL/6J female mice were randomly divided into the normal control group,strengthen-iron 1 group and strengthen-iron 2 group,12 cases in each group.The normal control group with normal diet(310mgFe/kg),strengthen-iron 1 group and strengthen-iron 2 group were given high -iron diets(respectively with 465mgFe/kg and 620mgFe/kg) after born 3 weeks.each group body,uterus and ovary mass after 2 weeks were checked;colorimetric method was used to detect the serum iron level;the serum follicle stimulating hormone (FSH) and luteinizing hormone(LH) were detected by chemiluminescent immunoassay.Results The body of mice serum iron levels,uterine ovarian index (uterine ovarian wet mass/body mass) and follicle stimulating hormone(FSH) level of strengthen-iron 1 group and strengthen-iron 2 group were higher than those of normal control group (F =9.11,11.11,7.09,all P ＜ 0.01).Luteinizing hormone (LH) level of the strengthen-iron group was higher than those of normal control group (F =3.89,P ＜ 0.05).Conclusion Uterine ovarian index,follicle stimulating hormone level and luteinizing hormone level were affected with increased serum iron level;It suggests that the increasing serum iron level can cause female mice sexual maturity in advance.

Actins ; metabolism ; Adenoma, Pleomorphic ; congenital ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Fibrosarcoma ; metabolism ; pathology ; Humans ; Infant ; Male ; Nasopharyngeal Neoplasms ; congenital ; metabolism ; pathology ; surgery ; Rhabdomyosarcoma ; metabolism ; pathology ; Salivary Gland Neoplasms ; congenital ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

OBJECTIVETo discuss the effect of surgical staging and using craft bone with vancomycin for the treatment of calcaneal fractures.

METHODSFrom January 2006 to December 2012,13 patients with open calcaneal fractures were treated including 9 males and 4 females with an average of 35.2 years old ranging from 23 to 66. All cases were emergency cases. According to Sanders classification of calcaneal fractures, 2 cases were type II, 7 cases were type III, 4 cases were type IV. According to Gustilo-Anderson soft tissue injury classification, 8 cases were type II, 2 cases were type III A, 2 cases were type III B, 1 case were type III C. Firstly a thorough debridement or VSD procedures were applied,secondly calcaneal fracture were treated with open reduction, plate fixation and bone graft complex with antibiotics. Based on clinical examination, radiographic evaluation, and American Foot and Ankle Surgery Society (AOFAS), ankle function were evaluated after operation.

RESULTSOpen wounds were headed after dressing and repairing,, lateral calcaneal wound were healed during the first period. All patients were followed up for 6 to 36 months (means 14.5 months). Fracture healing time was 14 to 20 weeks (means 16.2 weeks). Last follow-up AOFAS ankle-hindfoot score was (80.0 +/- 7.4) ranging from 55 to 95.

CONCLUSIONFor patients with open fractures, through reasonable clinical evaluation, staging operation, using bone graft with antibiotics can reduce the incidence of postoperative wound infection and promote fracture healing.

Adult ; Aged ; Anti-Bacterial Agents ; administration & dosage ; Bone Transplantation ; methods ; Calcaneus ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; Fracture Healing ; Fractures, Open ; surgery ; Humans ; Male ; Middle Aged

Objective To investigate the change of serum cystatin C (CC) level and its clinical significance in elderly patients with obstructive sleep apnea hypopnea syndrome (OSAHS),and to evaluate the diagnostic value of serum CC for renal impairment in elderly OSAHS patients.Methods Elderly snoring subjects (age ≥60 years) undergoing sleep apnea monitoring in our sleep laboratory were recruited.Patients were divided into simple snoring group,mild OSAHS group,moderate OSAHS group and severe OSAHS group according to the diagnostic criteria of American academy of sleep medicine.Anthropometric characteristics,lipid profiles,blood glucose,creatinine,estimated glomerular filtration rate (eGFR) and serum CC were compared between groups after age,gender and basic diseases were adjusted.The independent risk factors associated with serum CC were analyzed by Spearman's rank correlation and stepwise linear regression.Results Totally 89 elderly patients [70males and 29 females,aged (68.4±6.3) years in average] were collected.21 subjects were grouped as simple snoring,14 subjects as mild OSAHS,21 subjects as moderate OSAHS and 33 subjects as severe OSAHS.There were no differences in age,gender,basic diseases (hypertension and diabetes),lipid profiles,creatinine and eGFR among groups.The levels of body mass index,systolic blood pressure,diastolic blood pressure and serum CC were higher in severe OSAHS group than in simple snoring group [(28.3±3.9) vs.(24.6±5.9),(136.55±16.14) mm Hgvs.(122.43±16.64) mm Hg,(89.18±11.92) mm Hgvs.(78.10±9.55) mm Hg,(0.95±0.22) mg/L vs.(0.76±0.13)mg/L,respectively,all P＜0.05].Serum CC was significantly correlated with apnea hypopnea index (AHI),oxygen desaturation index,creatinine,eGFR,high sensitive C reactive protein (r=0.397,0.347,0.275,－0.354,0.254 respectively,all P％0.05).Regression analysis showed that AHI was an independent factor for serum CC (β=0.449,P＜ 0.001).Conclusions Serum CC level is increased in elderly patients with severe OSAHS.AHI is an independent factor for the increase of serum CC.Serum CC can be as an index for the early impairment of renal function in patients with OSAHS.

AIM: To determine the association between subfoveal choroidal thickness before therapy and therapeutic activity in diabetic macular edema.
METHODS: The current study was a retrospective study, which included 32 patients ( 32 eyes ) diagnosed with diabetic retinopathy and macular edema. All the patients were firstly treated with intravitreal injections of ranibizumab. Main outcome measures were included the subfoveal choroidal thickness, central macular thickness and best-corrected visual acuity ( BCVA) at preoperation and postoperative visit at 3mo.
RESULTS: After 3 monthly intravitreal injections of ranibizumab, the BCVA was significantly higher than that before therapy and accompanied with significantly reduced thickness of subfoveal choroid and central fovea of macula. Spearman analysis was revealed that a greater baseline subfoveal choroidal thickness was associated with a better BCVA (rs=0. 544, P=0. 036).
CONCLUSION:In the therapy of intravitreal injections of ranibizumab on diabetic macular edema, there seems to be a better BCVA in the patients with a greater baseline subfoveal choroidal thickness. Therefore, baseline subfoveal choroidal thickness may be a useful predictor for the therapy of diabetic macular edema.

? AlM: To evaluate the clinical application of simply performing phacoemulsification or combining intravitreal Ranibizumab injection in the treatment of cataract combined with diabetic retinopathy.
?METHODS:Forty-six patients (46 eyes) were recruited in this study. All of the patients were non-proliferative diabetic retinopathy without significant macular edema. They were randomly divided into two groups, the control group simply performed phacoemulsification, while the study group performed intravitreal Ranibizumab injection and phacoemulsification. Observation of indicators included the condition of best corrected visual acuity (BCVA), intraocular pressure, macular retinal thickness and complication at preoperative and postoperative 1, 6mo.
? RESULTS: BCVA and macular retinal thickness of patients in two groups had no differences in the preoperative and postoperative 1mo. At postoperative 6mo, the BCVA of the study group was better than that in the control group, while its macular retinal thickness was thinner than that in the control group (P<0. 05). The ratio of macular edema ( central macular thickness was >60μm than that in control group) was 13. 0% eyes in the study group which was significantly lower than the control group (47. 8%;P = 0. 033). The complications was no significant differences in two groups and neither occurred severe complications.
?CONCLUSlON: lntravitreal Ranibizumab injection can reduce the development of macular edema and improve the BCVA after phacoemulsification.